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Comparative Study of Navigated Versus Freehand Osteochondral Graft Transplantation of the Knee.

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Title: Comparative Study of Navigated Versus Freehand Osteochondral Graft Transplantation of the Knee.
Authors: Koulalis, Dimitrios1,2, Di Benedetto, Paolo1,3, Citak, Mustafa1, O'Loughlin, Padhraig1, Pearle, Andrew D.1, Kendoff, Daniel O.1 kendoffd@hss.edu
Source: American Journal of Sports Medicine. Apr2009, Vol. 37 Issue 4, p803-807. 5p. 2 Color Photographs.
Subject Terms: Osteochondrosis, Sports injuries, Orthopedic surgery, Knee, Tibial nerve, Femur, Nerve grafting, Transplantation of organs, tissues, etc.
Abstract: Background: Osteochondral lesions are a common sports-related injury for which osteochondral grafting, including mosaicplasty, is an established treatment. Computer navigation has been gaining popularity in orthopaedic surgery to improve accuracy and precision. Hypothesis: Navigation improves angle and depth matching during harvest and placement of osteochondral grafts compared with conventional freehand open technique. Study Design: Controlled laboratory study. Methods: Three cadaveric knees were used. Reference markers were attached to the femur, tibia, and donor/recipient site guides. Fifteen osteochondral grafts were harvested and inserted into recipient sites with computer navigation, and 15 similar grafts were inserted freehand. The angles of graft removal and placement as well as surface congruity (graft depth) were calculated for each surgical group. Results: The mean harvesting angle at the donor site using navigation was 4° (standard deviation, 2.3°; range, 1°-9°) versus 12° (standard deviation, 5.5°; range, 5°-24°) using freehand technique (P < .0001). The recipient plug removal angle using the navigated technique was 3.3° (standard deviation, 2.1°; range, 0°-9°) versus 10.7° (standard deviation, 4.9°; range, 2°-17°) in freehand (P < .0001). The mean navigated recipient plug placement angle was 3.6° (standard deviation, 2.0°; range, 1°-9°) versus 10.6° (standard deviation, 4.4°; range, 3°-17°) with freehand technique (P = .0001). The mean height of plug protrusion under navigation was 0.3 mm (standard deviation, 0.2 mm; range, 0-0.6 mm) versus 0.5 mm (standard deviation, 0.3 mm; range, 0.2- 1.1 mm) using a freehand technique (P = .0034). Conclusion: Significantly greater accuracy and precision were observed in harvesting and placement of the osteochondral grafts in the navigated procedures. Clinical studies are needed to establish a benefit in vivo. Clinical Relevance: Improvement in the osteochondral harvest and placement is desirable to optimize clinical outcomes. Navigation shows great potential to improve both harvest and placement precision and accuracy, thus optimizing ultimate surface congruity. [ABSTRACT FROM AUTHOR]
Copyright of American Journal of Sports Medicine is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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DbLabel: Education Research Complete
An: 42519898
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PubTypeId: academicJournal
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  Label: Title
  Group: Ti
  Data: Comparative Study of Navigated Versus Freehand Osteochondral Graft Transplantation of the Knee.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Koulalis%2C+Dimitrios%22&quot;&gt;Koulalis, Dimitrios&lt;/searchLink&gt;&lt;relatesTo&gt;1,2&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Di+Benedetto%2C+Paolo%22&quot;&gt;Di Benedetto, Paolo&lt;/searchLink&gt;&lt;relatesTo&gt;1,3&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Citak%2C+Mustafa%22&quot;&gt;Citak, Mustafa&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22O&#39;Loughlin%2C+Padhraig%22&quot;&gt;O&#39;Loughlin, Padhraig&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Pearle%2C+Andrew+D%2E%22&quot;&gt;Pearle, Andrew D.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Kendoff%2C+Daniel+O%2E%22&quot;&gt;Kendoff, Daniel O.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;i&gt; kendoffd@hss.edu&lt;/i&gt;
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22American+Journal+of+Sports+Medicine%22&quot;&gt;American Journal of Sports Medicine&lt;/searchLink&gt;. Apr2009, Vol. 37 Issue 4, p803-807. 5p. 2 Color Photographs.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Osteochondrosis%22&quot;&gt;Osteochondrosis&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Sports+injuries%22&quot;&gt;Sports injuries&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Orthopedic+surgery%22&quot;&gt;Orthopedic surgery&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Knee%22&quot;&gt;Knee&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Tibial+nerve%22&quot;&gt;Tibial nerve&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Femur%22&quot;&gt;Femur&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Nerve+grafting%22&quot;&gt;Nerve grafting&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Transplantation+of+organs%2C+tissues%2C+etc%2E%22&quot;&gt;Transplantation of organs, tissues, etc.&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Osteochondral lesions are a common sports-related injury for which osteochondral grafting, including mosaicplasty, is an established treatment. Computer navigation has been gaining popularity in orthopaedic surgery to improve accuracy and precision. Hypothesis: Navigation improves angle and depth matching during harvest and placement of osteochondral grafts compared with conventional freehand open technique. Study Design: Controlled laboratory study. Methods: Three cadaveric knees were used. Reference markers were attached to the femur, tibia, and donor/recipient site guides. Fifteen osteochondral grafts were harvested and inserted into recipient sites with computer navigation, and 15 similar grafts were inserted freehand. The angles of graft removal and placement as well as surface congruity (graft depth) were calculated for each surgical group. Results: The mean harvesting angle at the donor site using navigation was 4&#176; (standard deviation, 2.3&#176;; range, 1&#176;-9&#176;) versus 12&#176; (standard deviation, 5.5&#176;; range, 5&#176;-24&#176;) using freehand technique (P &lt; .0001). The recipient plug removal angle using the navigated technique was 3.3&#176; (standard deviation, 2.1&#176;; range, 0&#176;-9&#176;) versus 10.7&#176; (standard deviation, 4.9&#176;; range, 2&#176;-17&#176;) in freehand (P &lt; .0001). The mean navigated recipient plug placement angle was 3.6&#176; (standard deviation, 2.0&#176;; range, 1&#176;-9&#176;) versus 10.6&#176; (standard deviation, 4.4&#176;; range, 3&#176;-17&#176;) with freehand technique (P = .0001). The mean height of plug protrusion under navigation was 0.3 mm (standard deviation, 0.2 mm; range, 0-0.6 mm) versus 0.5 mm (standard deviation, 0.3 mm; range, 0.2- 1.1 mm) using a freehand technique (P = .0034). Conclusion: Significantly greater accuracy and precision were observed in harvesting and placement of the osteochondral grafts in the navigated procedures. Clinical studies are needed to establish a benefit in vivo. Clinical Relevance: Improvement in the osteochondral harvest and placement is desirable to optimize clinical outcomes. Navigation shows great potential to improve both harvest and placement precision and accuracy, thus optimizing ultimate surface congruity. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: &lt;i&gt;Copyright of American Journal of Sports Medicine is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1177/0363546508328111
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 5
        StartPage: 803
    Subjects:
      – SubjectFull: Osteochondrosis
        Type: general
      – SubjectFull: Sports injuries
        Type: general
      – SubjectFull: Orthopedic surgery
        Type: general
      – SubjectFull: Knee
        Type: general
      – SubjectFull: Tibial nerve
        Type: general
      – SubjectFull: Femur
        Type: general
      – SubjectFull: Nerve grafting
        Type: general
      – SubjectFull: Transplantation of organs, tissues, etc.
        Type: general
    Titles:
      – TitleFull: Comparative Study of Navigated Versus Freehand Osteochondral Graft Transplantation of the Knee.
        Type: main
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          Name:
            NameFull: Koulalis, Dimitrios
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            NameFull: Di Benedetto, Paolo
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            NameFull: Citak, Mustafa
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            NameFull: O'Loughlin, Padhraig
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            NameFull: Pearle, Andrew D.
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            NameFull: Kendoff, Daniel O.
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            – D: 01
              M: 04
              Text: Apr2009
              Type: published
              Y: 2009
          Identifiers:
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              Value: 03635465
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              Value: 37
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              Value: 4
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            – TitleFull: American Journal of Sports Medicine
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